Study to Evaluate the Safety and Efficacy of Two Contraceptive Vaginal Rings Delivering a Daily Dose of 1500 or 2500 μg of CDB-2914

A Phase 2, Randomized Study to Evaluate the Safety and Efficacy of Two Contraceptive Vaginal Rings Delivering a Daily Dose of 1500 or 2500 μg of CDB-2914 on Inhibition of Ovulation, Endometrial Changes and Bleeding Patterns in Normal Cycling Women

The purpose of this study is to to determine pharmacodynamic effects of a vaginal ring delivering either 1,500 or 2,500 μg of CDB-2914 per day during 6 months of treatment on:

1. follicular function and inhibition of ovulation
2. the endometrium
3. bleeding patterns; and also to assess safety including effects on the endometrium

Study Overview

• Status: Completed
• Conditions: Contraception
• Intervention / Treatment: Drug: CDB-2914

• Study Type: Interventional
• Enrollment (Actual): 55
• Phase: Phase 2

Contacts and Locations

Study Locations

• Chile
  • Santiago, Chile
    • Instituto Chileno de Medicina Reproductiva
• Dominican Republic
  • Santo Domingo, Dominican Republic
    • Profamilia
• United States
  • Oregon
    • Portland, Oregon, United States, 97239
      • Oregon Health & Science University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 40 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Healthy women of reproductive age (21-40 years)
• Not at risk for pregnancy based on one of the following
• subject has undergone sterilization
• subject is monogamous and her male partner has undergone sterilization
• subject agrees to be abstinent for the entire duration of the study (Oregon site only)
• subject does not have sex with men (Oregon site only)
• Have regular menstrual cycles of 25-35 days duration
• Have an intact uterus and both ovaries
• Will be able to comply with the protocol
• Capable of giving informed consent

Exclusion Criteria:

• Women participating in another clinical trial
• Women not living in the catchment area of the clinic
• Known hypersensitivity to progestins or antiprogestins
• Known hypersensitivity to silicone rubber
• Any chronic disease
• All contraindications to oral contraceptive use, including
• Thrombophlebitis or thromboembolic disorders
• Past history of deep vein thrombophlebitis or thromboembolic disorders
• Past or current cerebrovascular or coronary artery disease
• Migraine with focal aura
• Known or suspected carcinoma of the breast
• Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia
• Undiagnosed abnormal genital bleeding
• Cholestatic jaundice of pregnancy or jaundice with prior pill use
• Hepatic adenomas or carcinomas
• Known or suspected pregnancy
• Desire to get pregnant during the study (through the use of reproductive technology for sterilized women or vasectomy reversal for sterilized partners)
• Breastfeeding
• Undiagnosed vaginal discharge or vaginal lesions or abnormalities
• Elevated Prolactin levels (above laboratory normal values)
• Women with a current abnormal Pap
• In accordance with the Bethesda system of classification smear suggestive of high-grade pre-cancerous lesion(s), including HGSIL, are excluded
• Women with LGSIL or ASCUS/high-risk HPV positive may participate if further evaluated with colposcopy and biopsy and no evidence of a lesion with a severity > CIN I is present and/or endocervical curettage is negative
• Women with a biopsy finding of CIN I should have follow up for this finding per standard of care; women are excluded it treatment is indicated
• In accordance with other Pap class systems
• Women with high grade dysplasia are excluded
• Women with low grade dysplasia or CIN I interpretation on Pap smear may participate based on Investigator discretion and provided there is appropriate follow up in accordance with local standards of care
• Known benign or malignant liver tumors; known active liver disease
• Cancer (past history of any carcinoma or sarcoma)
• Medically diagnosed severe depression currently or in the past
• Known or suspected alcoholism or drug abuse
• Abnormal serum fasting clinical chemistry values
• Women with known abnormal thyroid status
• Women with known impaired hypothalamic-pituitary-adrenal reserve
• Average diastolic BP > 85 mm or systolic BP >135 mm Hg after 5-10 minutes rest
• Body mass index(BMI) > 29.0
• Smoking in women who are 35 years and over or will be 35 years during the course of the trial; women < 35 years who smoke greater than 15 cigarettes per day must be evaluated by the PI for inclusion based on risk factors that would increase their risk for CVD and thromboembolism, e.g. lipid levels, glucose level, BP, BMI, family history of CVD at a young age
• Women with severe cystoceles or rectoceles
• Use within the past 2 months of any implanted hormonal contraceptives including Mirena [progestin containing intrauterine system (IUS)] or Norplant (subdermal implant delivering LNG) NOTE: Removal of implanted hormonal contraceptives must have been for personal reasons unrelated to the purpose of enrollment in this study
• Current use of a non-hormone containing IUD. NOTE: Removal of an IUD must have been for personal reasons unrelated to the purpose of enrollment in this study
• Use of injectable contraceptives during the previous 3 months (e.g. Cyclofem) or 6 months (e.g. DMPA)
• Women who do not have at least two progesterone measurements during the control cycle of ≥10nmol/L will be excluded from further participation in the study (See Section 13.41)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: 1; Contraceptive Vaginal Ring delivering a daily dose of 1500 μg of CDB-2914	Drug: CDB-2914; Contraceptive Vaginal Rings delivering a daily dose of 1500 or 2500 μg of CDB-2914
Active Comparator: 2; Contraceptive Vaginal Ring delivering a daily dose of 2500 μg of CDB-2914	Drug: CDB-2914; Contraceptive Vaginal Rings delivering a daily dose of 1500 or 2500 μg of CDB-2914

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The primary efficacy variable will be ovulation suppression measured by progesterone serum levels.	All women will use the assigned CVR for 6 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Regular follow-up of follicle diameter will be made with USS to determine the timing of ovulation or, in the absence of ovulation, the fate of the dominant follicle.	All women will use the assigned CVR for 6 months
Clinical safety will be evaluated and the effects on the endometrium will be measured.	All women will use the assigned CVR for 6 months

Collaborators and Investigators

• Sponsor: Population Council

Study record dates

Study Major Dates

• Study Start: October 1, 2008
• Primary Completion (Actual): September 1, 2014
• Study Completion (Actual): September 1, 2014

Study Registration Dates

• First Submitted: November 13, 2008
• First Submitted That Met QC Criteria: November 13, 2008
• First Posted (Estimate): November 14, 2008

Study Record Updates

• Last Update Posted (Actual): August 15, 2017
• Last Update Submitted That Met QC Criteria: August 11, 2017
• Last Verified: August 1, 2017

More Information

Terms related to this study

• Keywords: CDB-2914; ovulation; endometrial changes; bleeding patterns; Contraceptive Vaginal Rings; normal cycling women; Inhibition of ovulation, endometrial changes and bleeding patterns in normal cycling women
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Contraceptive Agents, Hormonal; Contraceptive Agents; Reproductive Control Agents; Contraceptive Agents, Female; Ulipristal acetate
• Other Study ID Numbers: Population Council #422